Background Individuals with chronic pain have been reported to have an increased incidence of psychological morbidities. We aimed to examine the prevalence of anxiety, depression, disability, alexithymia, insomnia, and sleep quality in patients having chronic low back pain (LBP) and study their association with the severity of pain and any disability arising from it. Methods This descriptive study was conducted in a tertiary care teaching hospital setting. Fifty adults with nonspecific LBP of > 6-week duration were included. Study instruments employed were patient health questionnaire-9 for depression, generalized anxiety disorder-7 for anxiety, visual analogue scale (VAS) score for pain, Oswestry disability index (ODI) to assess disability, Toronto alexithymia scale-20 for alexithymia, and insomnia severity index and Pittsburgh sleep quality index for insomnia. Descriptive results were expressed as numbers, means, and proportions. Association study between variables was performed using Fisher’s exact test. Results Mean ODI score was 31.54% (95% CI, 26.09–36.99); mean VAS score was 6.08 (95% CI, 5.35–6.81). Insomnia of varying severity was found in 29 patients. Sleep quality was reported as good by 23 patients. One patient had alexithymia. There was significant association between the level of disability and depression, anxiety, insomnia, and sleep quality. The severity of pain had significant association with insomnia but the association with anxiety, depression, alexithymia, and sleep quality was not significant. Conclusions Patients with chronic LBP do have associated psychological comorbidities of varying extent. A “patient-centric” approach when treating patients with chronic LBP is necessary, so that appropriate evaluation of psychiatric and psychosocial comorbidities, sleep problems, and quality of life is done as part of their routine management to ensure the desired outcomes.

Thirty-one cases of epidermoid carcinoma found in 106 cases of carcinoma of the rectum and anal canal are reviewed. Clinical presentation and management are presented. Probable factors in the greater than usual incidence of epidermoid carcinomas of the anorectum are discussed. Indications for radiation therapy, local excision, and abdominoperineal and inguinal block dissection are presented.

Background: COVID-19 pandemic also known as Corona virus pandemic, is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV 2). In India, the first case of COVID-19 was reported on 30 January 2020 while in Madhya Pradesh on 20 March 2020 and in Rewa on 27 April 2020. Nearly 95 % of people recovered fromCOVID-19, and nearly three to five percent of cases needed Intensive Care Unit care and most of them needed mechanical ventilation. Materials and Methods: This was a hospital based cross-sectional study, done among 75 clinical or RT-PCR confirmed cases of COVID-19 infection admitted to the ICU of tertiary care unit. Results: In the present study, 63% were male and maximum (35%) belonged to 41-60 years of age. The most common symptom was fever at the time of admission to the hospital. Co-morbidity was reported in 21(28%) of patients. Out of these, majority of patients recorded combination of hypertension and diabetes as the most common comorbidity. Conclusion: Delayed medical intervention, advanced age, and the presence of underlying health conditions, such as cardiovascular disease, diabetes, etc., are known risk factors for severe illness and can contribute to worse outcomes and increased mortality in COVID-19 patients. Keywords: COVID -19, Covid mortality, comorbidity, ICU Outcome, Pneumonia, Tertiary care

Objective: COVID-19 pandemic has had significant impacts on healthcare systems across the world. However, its impact on healthcare systems in Low- and Middle-Income Countries (LMICs) has been especially devastating, resulting in restricted access to healthcare. The present study was conducted to assess healthcare access for non-communicable diseases (NCDs) in Central India. Design: Inductive and deductive thematic analysis of in-depth semi-structured interviews. Setting: Study was conducted in communities of two urban and rural districts of central India. Participants: Interviewed participants included PLNCDs, their caregivers, community dwellers, CHWs such as, Accredited Social Health Activists (ASHAs) and Anganwadi Workers (AWWs), Medical Officers, and Community Leaders. Recruitment of the participants was done via purposive and convenience sampling. Result: A total of fifty Key Informant Interviews were (KIIs) conducted. All participants reported facing considerable difficulties while trying to access care from both public as well as private healthcare facilities. Absence of staff, equipment and medicines, restricted commute, misconceptions regarding the spread of COVID-19, and the stigma attached to COVID-19 infection acted as major barriers to accessing care, while door-to-door visits by community health workers, community support, and presence of privately owned healthcare facilities in the vicinity acted as facilitators. Conclusion: In our study, we found that continued functioning of primary healthcare centres, ensuring uninterrupted supply of medicine and effective dissemination of information regarding COVID-19 could have acted to ease access to healthcare. Going ahead, capacity building to offset the impact of future emergencies and pandemics should be a crucial consideration while developing resilient healthcare systems.

Background: India’s flagship program on adolescent health – Rashtriya Kishor Swasthya Karyakram (RKSK) emphasises the importance of strengthening Adolescent Friendly Health Clinics (AFHCs) under its facility-based approach for improving the health of adolescents. AFHCs are intended to provide targeted intervention in six domains – nutrition, injuries & violence (including gender-based violence), mental health, sexual & reproductive health, substance abuse and noncommunicable diseases. Objective: The current study was conducted to assess the determinants of awareness and utilisation of AFHC services in districts with RKSK services in Madhya Pradesh. Subjects: In total, 1605 adolescents (both males and females) within the age group of 10–19 years were included in the study. Methods: Multistage stratified random sampling was employed to enrol participants from three districts of Madhya Pradesh, where AFHC services have been launched. Results: The mean age of the participants was 15.07 ± 2.32 years. Only 153 (9.5%) adolescents were aware of AFHC services. On multivariate logistic regression, awareness of AFHC was seen to be associated with being aware of RKSK, being a part of the peer educator-led peer group, having had adolescent health days organised in the village and belonging from one of the financially better off districts. Utilisation rate of AFHC services was lower still – at 2.74%. Conclusion: Both awareness and utilisation of AFHC services remain very low among adolescents. There is a pressing need to focus on awareness generation campaigns – via mass media, but more importantly, through community health workers and peer educators – in order to sensitise target beneficiaries about the available services.